Who’s gutting the laws that keep your medical records private? The feds are—and soon, Texas may too.

Since when are my medical records no longer private? Since April 14, 2003. Although the concept of a patient’s right to privacy dates back more than two thousand years to the creation of the Hippocratic oath, the Bush administration recently made an official change to the so-called privacy rule in the Health Insurance Portability and Accountability Act ( HIPAA), a federal law governing the electronic exchange of patient information between doctors, hospitals, and insurance companies. The original HIPAA rule, written in 1996, gave patients the strict right of consent before any of their records were shared; the new rule eliminates the consent requirement, opening your records to more than 600,000 “covered entities” for “routine purposes.” Even in Texas, which has its own privacy laws, your records may no longer be yours and yours alone.

Whoa—who are these “covered entities,” and what’s a “routine purpose”? In addition to the groups you might expect to have access to your files—doctors (for treatment) and insurance companies (for payment)—“covered entities” include the pharmaceutical industry, credit bureaus, and some employers (those with privately administered health care plans). As for a “routine purpose,” critics say the term can be defined so broadly that it may open the door to innumerable privacy violations.

Such as? Let’s say you work for one of the 600,000 “covered entities.” During your first few years of employment, the company looks at your records to track your medical bills on its health care plan. Concerned that you’re costing it too much money, the company eventually decides to lay you off. Another scenario: In a few years, your newly independent daughter applies for health insurance. The insurance company has access to your records, discovers a genetic test that shows that you and your descendants have a high risk for breast cancer, and then raises your child’s premiums as a result. “The possibilities for such violations are endless,” says Austin psychiatrist Deborah Peel, a plaintiff in a federal lawsuit filed last year against the new rule. “But the worst

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